The Science Journal of the American Association for Respiratory Care

2002 OPEN FORUM Abstracts

REPRODUCIBILITY OF FEV1 REVERSIBILITY TO IPRATROPIUM BROMIDE OVER ONE YEAR IN PATIENTS WITH COPD.

S Kesten1, S Menjoge1, P Cornelissen2. 1Boehringer Ingelheim, Ridgefield, CT, USA and 2Alkmaar, NL.

COPD is characterized by incomplete spirometric reversibility to pharmacologic intervention. Patients are often characterized as reversible (R) or irreversible (IR) on the basis of a single test day. We hypothesized that such characterization does not adequately profile a patientÕs ability to respond on subsequent test days. We therefore sought to determine the reproducibility of reversibility to ipratropium (as defined by a ³15% increase in FEV1 within 3 hours) and whether an ÒirreversibleÓ patient could show reversibility on another test day. A retrospective analysis was conducted of patients who completed all test days in a one-year COPD clinical trial where serial spirometry was performed before and after ipratropium 40 mcg (0.5, 1, 2, 3 hours) on 7 occasions. Mean (SE) FEV1 =1.22 (0.03)L, mean (SE) age = 64 (0.8) years. Proportion (%) of patients showing reversibility on a given test day is noted in the table according to whether reversibility was achieved on day 1 (R day 1 vs. IR day 1).

Study Day 1 8 50 92 182 273 364
All (n=114) 80 77 83 77 70 68 65
R day 1 (n=91) 100 81 87 84 75 73 67
IR day 1 (n=23) 0 61 70 52 52 52 57

Of 7 test days, only 0.9% were always IR and 33% were always R. Approximately 83% of patients demonstrated R on at least 4/7 test days. In conclusion, reversibility to ipratropium 40 mcg is frequent and a response of less than 15% on a given test day does not preclude a response on a subsequent test day.

This work is supported by Boehringer Ingelheim

OF-02-151

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